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[Sparkler]

Hi there

I am on evorel 25 patches and 200mg of utrogestan for 12 days each month. I am now in month 3 and have had no bleed at all. On day 9 of the Utro I get the very slightest smear of discolouration, then nothing until the next month. I am seeing the doc for review on 30th of this month, and wanted to increase to evorel 50, but he doesn't know much about the menopause at all, so I am asking you ladies.

I am worried he will say the hrt isn't working for me and insist I change it, but I would really just like to know why this is happening. Before the hrt I had 5 periods in a whole year then 3 periods in 2 months, so would have expected something by now.

Thoughts? Thank you in anticipation of any help or advice.
S

[MicheleMaBelle]

Sounds like the Utrogestan is keeping the lining nice and thin so there's nothing to come away. There shouldn't be an issue switching to 50 mcg patches if the 25mcg ones aren't controlling the symptoms. Just ask for them if this is the case. It's trial and error I'm afraid until you find something that suits you. Your GP should know this although you may have to educate them!
You can always give it more time to see if things settle but I'd certainly be monitoring the expected bleed if you do switch to the larger patches.

[Nik2502]

When I was on Femeston I didn't bleed for years and was told it was fine as the womb lining was being kept thin. Consultant reassured me it was fine x

[Sparkler]

Oooh, thank you! Perhaps I may just be exceptionally lucky and not bleed 

[Katejo]

Oooh, thank you! Perhaps I may just be exceptionally lucky and not bleed 

  I have been on Evorel Conti for 6 weeks and no bleed at all yet.

[Hurdity]

The extent to which a woman will bleed on sequential HRT depends both on the dose of oestrogen in relation to progesterone, and her particular biology as well as anything slightly abnormal in the womb eg fibroids or polyps (think I might have said this on another thread just now as well!)

According to the stats on this website 15% of women do not bleed on cyclical HRT. I did at first when I started late peri and then while on a 28 day cycle my  bleeds stopped when I was well post-meno. This meant I could go onto a longer cycle (longer on oestrogen only) so I do get a bleed now.

In your case that regime of progesterone is clearly more than sufficient to protect your lining because you are on a very low dose oestrogen.

What is the reason for your wanting to increase oestrogen dose?

Your doc cannot insist on anything (unless there is a medical reason for you to stop HRT) - HRT and menopausal treatments are supposed to be an informed decision taking into account any medical considerations and your preferences - to be arrived at jointly!!!

If you want to increase to 50 mcg due to symptoms not being contolled on 25 mcg then you should be able to. Before you go to the doc try to anticipate what he might ask or say and rehearse your arguments for the treatment you would like and practise being polite but firm and show that you know what you're talking about!

Yes you've been lucky not to bleed but if you increase oestrogen dose then you will most likely bleed as long as you don't mind that?

Sorry can't remember where you are in menopause and how old you are...

Good luck!!!

Hurdity x